Achromycin V

Tetracycline comes as a capsule to take by mouth. It is usually taken two or four times daily. Tetracycline should be taken on an empty stomach, at least 1 hour before or 2 hours after meals or snacks. Drink a full glass of water with each dose of tetracycline. Do not take tetracycline with food, especially dairy products such as milk, yogurt, cheese, and ice cream. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take tetracycline exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Before taking tetracycline,

• tell your doctor and pharmacist if you are allergic to tetracycline, minocycline, doxycycline, demeclocycline, any other medications, or any of the ingredients in the tetracycline capsule. Ask your pharmacist for a list of the ingredients.
• tell your doctor and pharmacist what prescription and nonprescription medicines, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: anticoagulants ('blood thinners') such as warfarin (Coumadin, Jantoven), and penicillin.
• be aware that antacids containing magnesium, aluminum, calcium, or sodium bicarbonate, calcium supplements, zinc products, iron products, and laxatives containing magnesium interfere with tetracycline, making it less effective. Take tetracycline 2 hours before or 6 hours after antacids, calcium supplements, zinc products, and laxatives containing magnesium. Take tetracycline 2 hours before or 4 hours after iron preparations and vitamin products that contain iron. Take tetracycline 2 hours before or after zinc containing products.
• tell your doctor if you have or have ever had lupus (condition in which the immune system attacks many tissues and organs including the skin, joints, blood, and kidneys), or kidney disease.
• tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while taking tetracycline, call your doctor immediately. Tetracycline can harm the fetus.
• plan to avoid unnecessary or prolonged exposure to sunlight and to wear protective clothing, sunglasses, and sunscreen. Tetracycline may make your skin sensitive to sunlight. Tell your doctor right away if you get a sunburn.
• you should know that when tetracycline is used during pregnancy or in babies or children up to age 8, it can cause the teeth to become permanently stained. Tetracycline should not be used in children under age 8 unless your doctor decides it is needed.

THE USE OF DRUGS OF THE TETRACYCLINE CLASS DURING TOOTH DEVELOPMENT

(LAST HALF OF PREGNANCY, INFANCY AND CHILDHOOD TO THE AGE OF 8 YEARS) MAY CAUSE PERMANENT DISCOLORATION OF THE TEETH (YELLOW - GRAY-BROWN). This adverse reaction is more common during long-term use of the drugs but has been observed following repeated short-term courses. Enamel hypoplasia has also been reported. TETRACYCLINE DRUGS, THEREFORE, SHOULD NOT BE USED IN THIS AGE GROUP UNLESS OTHER DRUGS ARE NOT LIKELY TO BE EFFECTIVE OR ARE CONTRAINDICATED.

All tetracyclines form a stable calcium complex in any bone forming tissue. A decrease in fibula growth rate has been observed in premature infants given oral tetracycline in doses of 25 mg/kg every six hours. This reaction was shown to be reversible when the drug was discontinued.

Results of animal studies indicate that tetracyclines cross the placenta, are found in fetal tissues and can have toxic effects on the developing fetus (often related to retardation of skeletal development). Evidence of embryotoxicity has also been noted in animals treated early in pregnancy. If this drug is used during pregnancy or if the patient becomes pregnant while taking this drug, the patient should be apprised of the potential hazard to the fetus. Tetracycline drugs should not be used during pregnancy unless absolutely necessary.

If renal impairment exists, even usual oral or parenteral doses may lead to excessive systemic accumulation of the drug and possible liver toxicity. Under such conditions, lower than usual total doses are indicated, and, if therapy is prolonged, serum level determinations of the drug may be advisable.

Photosensitivity manifested by an exaggerated sunburn reaction has been observed in some individuals taking tetracyclines. Patients apt to be exposed to direct sunlight or ultraviolet lights should be advised that this reaction can occur with tetracycline drugs. Treatment should be discontinued at the first evidence of skin erythema.

The antianabolic action of the tetracyclines may cause an increase in BUN. While this is not a problem in those with normal renal function, in patients with significantly impaired renal function, higher serum levels of tetracycline may lead to azotemia, hyperphosphatemia and acidosis.